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RajendranNavaradnasinkam ,
CRI .
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INFECTIVE LESIONS
BACTERIAL DISEASES
SYPHILIS
GONORRHOEA
TUBERCULOSIS
LEPROSY
ACTINOMYCOSIS NOMA
ANUG
VIRAL DISEASES
ACUTE HERPETIC GINGIVOSTOMATITIS HERPES LABIALIS
HIV INFECTION
INFECTIOUS MONONUCLEOSIS
HERPES ZOSTER
MEASLES
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FUNGAL DISEASESFUNGAL DISEASES
SPOROTRICHOSISSPOROTRICHOSIS
HISTOPLASMOSISHISTOPLASMOSIS
CRYPTOCOCCOSISCRYPTOCOCCOSIS
MUCORMYCOSISMUCORMYCOSIS
TRAUMATIC CONDITIONSTRAUMATIC CONDITIONS
MECHANICALMECHANICAL
THERMALTHERMAL
CHEMICALCHEMICAL
FACTITIOUS INJURYFACTITIOUS INJURY
RADIATION INJURYRADIATION INJURY
IMMUNOLOGICAL DISORDERSIMMUNOLOGICAL DISORDERSAPHTHOUS ULCERAPHTHOUS ULCER
BECHETS SYNDROMEBECHETS SYNDROME
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REITERS SYNDROMEREITERS SYNDROME
ERYTHEMA MULTIFORMEERYTHEMA MULTIFORME
PEMPHIGUSPEMPHIGUSPEMPHIGOIDPEMPHIGOID
ULCERATIVE LICHEN PLANUSULCERATIVE LICHEN PLANUS
DISCOID LUPUS ERYTHEMATOUSDISCOID LUPUS ERYTHEMATOUS
SYSTEMIC DISEASESSYSTEMIC DISEASES
LEUKEMIALEUKEMIA
AGRANULOCYTOSISAGRANULOCYTOSIS
CYCLIC NEUTROPENIACYCLIC NEUTROPENIA
PERNICIOUS ANAEMIAPERNICIOUS ANAEMIA
CHRONS DISEASECHRONS DISEASE
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PRIMARY ORAL HERPES
History of generalized prodromal symptomsthat precede the orallesions by 1-2 days.
Small vesicles appear on the oral mucosa. They are thin walled
surrounded by inflammation. They rupture leaving shallow round
discrete ulcers.
Entire gingiva is edematous and inflammed.
ERYTHEMA MULTIFORME
Starts as a bullae on an erythematous base. It rapidly breaks into
irregular ulcers.Lesions are larger, irregular, deeper and often bleed.
Involvement of lips are prominent while gingiva is rare.
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CONTACT ALLERGIC STOMATITISCONTACT ALLERGIC STOMATITIS
Reaction occurs at the site of contact.Reaction occurs at the site of contact.
Includes burning sensation or soreness accompanied by erythemaIncludes burning sensation or soreness accompanied by erythemaand occasionally forming vesicles and ulcers.and occasionally forming vesicles and ulcers.
ACUTE NECROTIZING ULCERATIVE GIGIVITISACUTE NECROTIZING ULCERATIVE GIGIVITIS
Necrotic punched out ulcerationsNecrotic punched out ulcerations
mostly developing in the interdentalmostly developing in the interdental
papillae and marginal gingiva.papillae and marginal gingiva.
A gray pseudomembranous covering.A gray pseudomembranous covering.
Putrid halitosis and bad taste.Putrid halitosis and bad taste.
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RECURRENT APHTHOUS STOMATITISRECURRENT APHTHOUS STOMATITIS
Ulcers confined to oral mucosa with no other symptoms.Ulcers confined to oral mucosa with no other symptoms.
Recurrent crops of dozens of small ulcers throughout the oral mucosa.Recurrent crops of dozens of small ulcers throughout the oral mucosa.
Initially, a localized area of erythema develops, within hours, a smallInitially, a localized area of erythema develops, within hours, a smallwhite papule forms ulceration and gradually enlarges over the next 42-white papule forms ulceration and gradually enlarges over the next 42-72 hrs.72 hrs.
Individual lesions are round, symmetric and shallow.Individual lesions are round, symmetric and shallow.
Lesions less common on heavily keratinized palate or gingiva.Lesions less common on heavily keratinized palate or gingiva.
Healing occurs without scarring.Healing occurs without scarring.
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BEHCETS SYNDROMEBEHCETS SYNDROME
Triad of symptoms include recurrent oral ulcers, recurrent genitalTriad of symptoms include recurrent oral ulcers, recurrent genitalulcers and eye lesions.ulcers and eye lesions.Most common single site is the oral mucosa.Most common single site is the oral mucosa.Lesions are similar to recurrent aphthous ulcers.Lesions are similar to recurrent aphthous ulcers.
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RECURRENT HERPES SIMPLEX VIRAL INFECTIONRECURRENT HERPES SIMPLEX VIRAL INFECTION
Occurs in patient with previous history of herpes simplex infection.Occurs in patient with previous history of herpes simplex infection.
Prodromal period of tingling or burning, accompanied by edema at theProdromal period of tingling or burning, accompanied by edema at thesite of the lesion.site of the lesion.
Its followed by formation of a cluster of small vesicles.Its followed by formation of a cluster of small vesicles.
Large lesions are common in immuno suppressed individuals.Large lesions are common in immuno suppressed individuals.
PEMPHIGOUS VULGARISPEMPHIGOUS VULGARIS
Lesions begin as a classic bullae on aLesions begin as a classic bullae on a
noninflamed base.noninflamed base.
Oral lesions appear 3 months before skinOral lesions appear 3 months before skin
lesions.lesions.
Lesions are shallow and irregular, andLesions are shallow and irregular, and
others have detached epithelium at theothers have detached epithelium at the
periphery.periphery.
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CICATRICIAL PEMPHIGOIDCICATRICIAL PEMPHIGOID
Lesions present as intact vesicles of the gingival or other mucosalLesions present as intact vesicles of the gingival or other mucosal
surface but appear more as nonspecific erosionssurface but appear more as nonspecific erosions
BULLOUS PEMPHIGOIDBULLOUS PEMPHIGOID
Gingival lesions include edema, inflammation and desquamationGingival lesions include edema, inflammation and desquamation
with localized of discrete vesicle formation.with localized of discrete vesicle formation.
EROSIVE LICHEN PLANUSEROSIVE LICHEN PLANUS
Present as white lesion.Present as white lesion.
Presence of vesicles, bullae or irregular shallow ulcers of the oralPresence of vesicles, bullae or irregular shallow ulcers of the oralmucosa.mucosa.
Lesions present for weeks to months.Lesions present for weeks to months.
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HISTOPLAMOSISHISTOPLAMOSIS
Lesions appear as a papule, a nodule, an ulcer or a vegetation.Lesions appear as a papule, a nodule, an ulcer or a vegetation.
If a single lesion is left untreated, it progresses from a firm papule toIf a single lesion is left untreated, it progresses from a firm papule to
a nodule which ulcerates and slowly enlarges.a nodule which ulcerates and slowly enlarges.
MUCORMYCOSISMUCORMYCOSIS
ulceration of the palate, which results from necrosis due to invasionulceration of the palate, which results from necrosis due to invasion
of palatal vesicles.of palatal vesicles. The lesions is large and deep, causing denudation of underlyingThe lesions is large and deep, causing denudation of underlying
bone.bone.
Ulcers in gingiva, lip and alveolar ridge.Ulcers in gingiva, lip and alveolar ridge.
OSTEORADIONECROSISOSTEORADIONECROSIS
Ulceration in overlying skin or mucosa especially followingUlceration in overlying skin or mucosa especially followingextraction of a tooth, denture ulceration, trauma, etc.extraction of a tooth, denture ulceration, trauma, etc.
Secondary infections lead to radiation osteomyelitis.Secondary infections lead to radiation osteomyelitis.
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LEUKEMIALEUKEMIA
Gingival hyperplasia with bleeding in the most common oralGingival hyperplasia with bleeding in the most common oralmanifestation.manifestation.
Ulceration of the sulcular epithelium and necrosis of the connectiveUlceration of the sulcular epithelium and necrosis of the connectivetissue leads to severe spontaneous gingival bleeding.tissue leads to severe spontaneous gingival bleeding.
ANGULAR CHELITISANGULAR CHELITISFeeling of dryness of the mouth and burningFeeling of dryness of the mouth and burningsensation at the corner of the mouth.sensation at the corner of the mouth.
Epithelium at the commisures appearEpithelium at the commisures appear
wrinkled. In time, wrinkling becomes morewrinkled. In time, wrinkling becomes morepronounced to form deep fissures or crackspronounced to form deep fissures or crackswhich appear ulcerated, but which do notwhich appear ulcerated, but which do nottend to bleed.tend to bleed.
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SYPHILISSYPHILIS
PRIMARY SYPHILISPRIMARY SYPHILIS
ChancreChancre occurs on the lip, tongue, palate, gingiva, tonsils, etc.occurs on the lip, tongue, palate, gingiva, tonsils, etc. Chancre are ulcerated, indurated lesions covered by a grayish whiteChancre are ulcerated, indurated lesions covered by a grayish white
membrane and often mistaken for early carcinoma.membrane and often mistaken for early carcinoma.
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SECONDARY SYPHILISSECONDARY SYPHILIS Mucous patchesMucous patches are seen over the tongue, gingiva, larynx, pharynx,are seen over the tongue, gingiva, larynx, pharynx,
cheek, etc.cheek, etc.
Multiple mucous patches in the oral cavity coalesce together andMultiple mucous patches in the oral cavity coalesce together andform snail like track like ulcers.form snail like track like ulcers.
Papules are seen often at the angle of the mouth and they have aPapules are seen often at the angle of the mouth and they have atypicaltypical split peasplit pea like appearance.like appearance.
TERTIARY SYPHILISTERTIARY SYPHILIS GummaGumma are seen on the hard and soft palate, lips and tongue.are seen on the hard and soft palate, lips and tongue. They frequently ulcerate by central necrosis and have a punchedThey frequently ulcerate by central necrosis and have a punched
out edge with leathery floorout edge with leathery floor
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NOMANOMA
Formation of a painful, red, undurated papule over the alveolarFormation of a painful, red, undurated papule over the alveolar
margin.margin. It is soon followed by the formation of an ulcer which spreadsIt is soon followed by the formation of an ulcer which spreads
rapidly exposing the underlying bone. Ulcer extends to the mucosalrapidly exposing the underlying bone. Ulcer extends to the mucosalsurface of the lips and cheeks.surface of the lips and cheeks.
Later a dark area appears on the skin over the cheek which rapidlyLater a dark area appears on the skin over the cheek which rapidlyundergoes gangrenous necrosis.undergoes gangrenous necrosis.
A large hole of few inches in size develops on the cheek due toA large hole of few inches in size develops on the cheek due tosloughing of the tissue which exposes the inside of mouth, causingsloughing of the tissue which exposes the inside of mouth, causingsevere disfigurement.severe disfigurement.
ACUTE HERPETIC GINGIVOSTOMATITISACUTE HERPETIC GINGIVOSTOMATITIS
Reddening of the oral mucosa followed by diffuse, large, whitishReddening of the oral mucosa followed by diffuse, large, whitishulcers which are surrounded by a red ring of inflammation.ulcers which are surrounded by a red ring of inflammation.
Ulcers are often covered by purulent material.Ulcers are often covered by purulent material.
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HERPES ZOSTERHERPES ZOSTER
Produces clusters of vesicles over the face and oral mucosa on oneProduces clusters of vesicles over the face and oral mucosa on oneside of face with stinging pain and parasthesia in the region.side of face with stinging pain and parasthesia in the region.
Spreads along the distribution of the sensory nerve unilaterally onSpreads along the distribution of the sensory nerve unilaterally onone side of face while the other side is asymptomatic.one side of face while the other side is asymptomatic.
The fragile vesicle rupture and leaves a painful ulcer.The fragile vesicle rupture and leaves a painful ulcer.
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TRAUMATIC ULCERTRAUMATIC ULCER
Frequently develop on the tongue, vestibule, alveolar ridge or palate.Frequently develop on the tongue, vestibule, alveolar ridge or palate. The lesion exhibits solitary painful ulcer of short duration.The lesion exhibits solitary painful ulcer of short duration.
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